Monocid Side Effects

Note: This page contains information about the side effects of cefonicid. Some of the dosage forms included on this document may not apply to the brand name Monocid.

Applies to cefonicid: injectable powder for injection

General

Cefonicid (the active ingredient contained in Monocid) is generally well tolerated.[Ref]

Hypersensitivity

Hypersensitivity reactions are rare, and may include urticaria, rash, eosinophilia, and fever.[Ref]

Up to 20% of patients with penicillin allergy may demonstrate allergic reactions to cefonicid. Rare cases of a "flu-like syndrome" (fever, chronic fatigue, and myalgias) are reported in patients who received cefonicid for two weeks.

A case of occupational contact dermatitis due to cephalosporin allergy has been reported in a nurse who prepared cephalosporin solutions for administration to patients. The dermatitis resolved after the nurse stopped preparing the solutions.[Ref]

Gastrointestinal

A disulfiram-like reaction is associated with some cephalosporins, including cefonicid (the active ingredient contained in Monocid) which have a methylthiotetrazole ring in their chemical structure. This chemical moiety is associated with inhibition of aldehyde dehydrogenase, which may result in accumulation of acetaldehyde, especially after alcohol consumption. This mechanism is not proven with cefonicid, but is demonstrated with similar cephalosporins, such as cefamandole.

Pseudomembranous colitis has been reported in patients treated with cephalosporins. If diarrhea occurs and it is unresponsive to discontinuation of the drug and/or standard therapy, pseudomembranous colitis should be considered.

Elevations of serum transaminases may be important for patients with liver disease.[Ref]

Gastrointestinal effects include mild, reversible elevations of serum transaminases in 2% to 22% of patients. Nausea and vomiting, mild epigastric discomfort, and loose stools are reported, and may be more likely if this patient consumes alcohol. While no disulfiram-like reactions are associated with cefonicid, they are theoretically possible based on the chemical structure of the drug.[Ref]

Hematologic

Hematologic side effects include rare instances of thrombocytosis and thrombocytopenia, eosinophilia, positive Coombs' tests, and leukopenia.[Ref]

Renal

Interstitial nephritis has been reported with some cephalosporins. Reversible fever, azotemia, pyuria, and eosinophilia are the hallmarks of cephalosporin-induced interstitial nephritis.[Ref]

Renal adverse effects are rare. Increases in BUN and serum creatinine occur in less than 1% of patients.[Ref]

Genitourinary

Genitourinary side effects including increased incidences of vaginal yeast infections have been reported.[Ref]

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